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It is harder than ever to run a successful independent medical practice. As value-based reimbursement becomes more common alongside the fee-for-service model, physicians will be on the hook for demonstrating clinical outcomes and providing seamless care coordination in order to receive payment. In recent times, there have been a number…
Although reimbursement is a vital aspect within a claim’s life cycle, it is certainly not the only vital piece. It is important to recognise and distinguish each stage from the other within the total life cycle of a medical claim to decrease errors and cost. Most of the people believe…
Have you ever walked into the pharmacy and been told that your prescription requires a prior authorisation, but your doctor prescribed something for you, and you brought in your prescription, shouldn’t that be enough? What exactly is a prior authorisation, and why can’t you just pick up your prescription? Your…
More than half of Americans delay paying medical bills, according to a new revenue cycle report by West, and that is putting additional financial stress on the healthcare industry. In the past, providers received 90 percent of their reimbursement from insurance companies, but with the rise of high-deductible health plans, nearly a…
The Centers for Medicare & Medicaid Services (CMS) has established a new physician specialty code for Hospitalist. The new code for Hospitalist is C6. Effective April 1, 2017, a new physician specialty code for hospitalist will be. The new physician specialty code C6 has been designated for hospitalist. The new…
Medicare provides a vital foundation for the health and wellness of Americans who are 65 or older or have significant disabilities. The program currently covers a portion of health care costs for over 47 million individuals throughout the United States. Although Medicare has been a trusted health organization for almost…
Today, The Centers for Medicare & Medicaid Services (CMS) gave the public its first look at the newly designed Medicare card. The new Medicare card contains a unique, randomly-assigned number that replaces the current Social Security-based number. New Medicare Card Design CMS will begin mailing the new cards to people…
The two things providers hate when it comes to healthcare? High deductibles and patient refunds. Coincidentally, the two can play off each other. Deductibles are higher than ever and providers are trying to collect as much money up front as possible. So it’s not a bad problem to have. What…
ICD-10 accuracy codes reflect how medical practices treat their patients. Incorrect coding can lead to denied claims that hurt healthcare providers’ revenue streams. Unfortunately, sometimes when all the coding is done correctly, healthcare payers may not be able to hold up their end of the deal. ICD-10 accuracy codes reflect how medical…
Today, In the billing process the revenue cycle management is one of the most important functions for orthopedic practices. With proper billing, revenue will continue to come in with minimal delays minimizing stress and cash flow issues. When it comes to orthopedic billing, practices need to keep several important things in…
